Baby Delivery At Ambulance

He was born on the wheels, in the middle of a dusty village road near Coimbatore on Saturday afternoon. Two days after his birth, the cuddly baby boy invites curious glances and warm care at the government primary health centre at Vaagarampalayam hamlet, 20 kms from here. For he is the PHC's first "ambulance" baby- a tiny tot born inside an ambulance instead of a labour room. In rural Tamil Nadu, villagers are now dialling 108 for safe child delivery as ambulances turn into mobile labour rooms.

As 20-year-old Ambika Manikandan, wife of a farm labourer, went into intense labour at the PHC, the infant in the womb, passed stools or meconium. The PHC's medical officer, Dr Nirmala Devi immediately dialled 108, the telephone number of the Emergency Management and Research Institute (EMRI), which provides emergency care for patients and accident victims. Within minutes, the EMRI's fully-equipped ambulance arrived to shift Ambika to the Coimbatore Medical College Hospital. "I referred her to the CMCH because I feared there would be complications in the delivery," said Dr Nirmala.

However, as the ambulance sped down a few miles towards Thennampalayam village, the contractions increased and the baby was sliding out of the birth passage. The EMRI technician, J Shobana Devi and the PHC staff immediately swung into action. Writhing Ambika was put on saline, and the child was gently delivered from the womb, the umbilical chord was clasped. "I suctioned the child's mouth to remove the liquids," smiles a relieved Shobana Devi, who performed her first on-the-wheels delivery. After the successful delivery, the mother and child were safely transported back to the PHC.

"My child weighs 2.4 kgs and is active. I am also fine," says the elated mother, Ambika. Less than month after the `Dial 108 for emergency services' was launched in Coimbatore with nine ambulances, the EMRI technicians, who are graduates in Life Sciences, with a two-month emergency care training, have helped deliver two babies. In the wee hours of December 12, precisely at 1.24 a.m, parents of another woman in labour, Sudha at Malumichampatti village near Coimbatore, desperately dialled 108. In the next 10 minutes, the ambulance arrived along with a young technician. But 24-year-old Sudha, bearing her second child, just could not drag her feet and plonked at the entrance of her hut. Swiftly, the technician Indirarani, looked up the cervix and saw the child easing out.

"I was a little scared initially. But picked up the guts to do the delivery right on the road on a mat," says Indurani. After a few minutes of struggle, a girl baby, was safely delivered at 1.45 a.m. And the child and the mother were shifted to the primary health centre by the ambulance. "Fortunately, for them, a neighbour knew about 108 services and asked them to call us," says Indurani. In rural Tamil Nadu with a significant maternal and infant mortality rate, the 108 ambulance is a life saving service, especially for the poor, who have to head to the PHCs in a rickety bus, motorcycles or a bullock cart. "They are very fast and come whenever we call them. It is a big service to the rural people in emergency situations," says Dr Nirmala Devi.

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